Back Pain

Back Pain

What Are the Risk Factors for Back Pain?

Although anyone can have back pain, a number of factors increase your risk. They include:
Age: The first attack of low back pain typically occurs between the ages of 30 and 40. Back pain becomes more common with age.
Fitness level: Back pain is more common among people who are not physically fit. Weak back and abdominal muscles may not properly support the spine. "Weekend warriors" - people who go out and exercise a lot after being inactive all week – are more likely to suffer painful back injuries than people who make moderate physical activity a daily habit. Studies show that low-impact aerobic exercise is good for the discs that cushion the vertebrae, the individual bones that make up the spine.
Diet: A diet high in calories and fat, combined with an inactive lifestyle, can lead to obesity, which can put stress on the back.
Heredity: Some causes of back pain, including disc disease, may have a genetic component.
Race: Race can be a factor in back problems. African American women, for example, are two to three times more likely than white women to develop spondylolisthesis, a condition in which a vertebra of the lower spine – also called the lumbar spine – slips out of place.

How Is Back Pain Treated?

Treatment for back pain generally depends on what kind of pain you experience: acute or chronic.

Acute Back Pain

Acute back pain usually gets better on its own and without treatment, although you may want to try acetaminophen, aspirin, or ibuprofen to help ease the pain. Perhaps the best advice is to go about your usual activities as much as you can with the assurance that the problem will clear up. Getting up and moving around can help ease stiffness, relieve pain, and have you back doing your regular activities sooner. Exercises are not usually advisable for acute back pain, nor is surgery. Chronic Back Pain

Treatment for chronic back pain falls into two basic categories: the kind that requires an operation and the kind that does not. In the vast majority of cases, back pain does not require surgery. Doctors will almost always try nonsurgical treatments before recommending surgery. In a very small percentage of cases – when back pain is caused by a tumor, an infection, or a nerve root problem called cauda equina syndrome, for example - prompt surgery is necessary to ease the pain and prevent further problems.

Following are some of the more commonly used treatments for chronic back pain.

Nonoperative treatments

Hot or cold: Hot or cold packs – or sometimes a combination of the two – can be soothing to chronically sore, stiff backs. Heat dilates the blood vessels, improving the supply of oxygen that the blood takes to the back and reducing muscle spasms. Heat also alters the sensation of pain. Cold may reduce inflammation by decreasing the size of blood vessels and the flow of blood to the area. Although cold may feel painful against the skin, it numbs deep pain. Applying heat or cold may relieve pain, but it does not cure the cause of chronic back pain.

Exercise: Although exercise is usually not advisable for acute back pain, proper exercise can help ease chronic pain and perhaps reduce its risk of returning. The following four types of exercise are important to general physical fitness and may be helpful for certain specific causes of back pain:

Flexion: The purposes of flexion exercises, which are exercises in which you bend forward, are to 1) widen the spaces between the vertebrae, thereby reducing pressure on the nerves; 2) stretch muscles of the back and hips; and 3) strengthen abdominal and buttock muscles. Many doctors think that strengthening the muscles of the abdomen will reduce the load on the spine. One word of caution: If your back pain is caused by a herniated disc, check with your doctor before performing flexion exercises because they may increase pressure within the discs, making the problem worse.

Extension: With extension exercises, you bend backward. They may minimize radiating pain, which is pain you can feel in other parts of the body besides where it originates. Examples of extension exercises are leg lifting while lying prone and raising the trunk while lying prone. The theory behind these exercises is that they open up the spinal canal in places and develop muscles that support the spine.

Stretching: The goal of stretching exercises, as their name suggests, is to stretch and improve the extension of muscles and other soft tissues of the back. This can reduce back stiffness and improve range of motion.

Aerobic: Aerobic exercise is the type that gets your heart pumping faster and keeps your heart rate elevated for a while. For fitness, it is important to get at least 30 minutes of aerobic (also called cardiovascular) exercise three times a week. Aerobic exercises work the large muscles of the body and include brisk walking, jogging, and swimming. For back problems, you should avoid exercise that requires twisting or vigorous forward flexion, such as aerobic dancing and rowing, because these actions may raise pressure in the discs and actually do more harm than good. In addition, avoid high-impact activities if you have disc disease. If back pain or your fitness level makes it impossible to exercise 30 minutes at a time, try three 10-minute sessions to start with and work up to your goal. But first, speak with your doctor or physical therapist about the safest aerobic exercise for you.

Medications: A wide range of medications are used to treat chronic back pain. Some you can try on your own. Others are available only with a doctor's prescription. The following are the main types of medications used for back pain.

Analgesics: Analgesic medications are those designed specifically to relieve pain. They include over-the-counter acetaminophen (Tylenol) and aspirin, as well as prescription narcotics, such as oxycodone with acetaminophen (Percocet) or hydrocodone with acetaminophen (Vicodin). Aspirin and acetaminophen are the most commonly used analgesics; narcotics should only be used for a short time for severe pain or pain after surgery. People with muscular back pain or arthritis pain that is not relieved by medications may find topical analgesics helpful. These creams, ointments, and salves are rubbed directly onto the skin over the site of pain. They use one or more of a variety of ingredients to ease pain. Topical analgesics include such products as Zostrix, Icy Hot, Kool Comfort and Ben Gay.

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